From serving 'frequent fliers' to managing health for an entire population

Q&A With Mason Beard — Chief Solutions Officer, Philips Population Health Management

This content is sponsored by Philips

In a rapidly changing healthcare environment, healthcare organizations must increasingly manage the health of entire populations in an effective and sustainable way. This represents a substantial shift in the way health systems do business. How do they address this challenge while working to provide seamless care across an entire health system?

Mason Beard, chief solutions officer for Philips Population Health Management (PHM) and co-founder of Wellcentive (acquired by Philips in 2016) discusses why it is important to broaden your focus from serving the health needs of "frequent fliers" to managing health for the entire population.

Q: If high utilizers account for about half of healthcare expenditures, why is it important to address other population segments?

Mason Beard: While it makes sense for organizations to start with the high utilizers, as you gain more experience managing risk, you need integrated strategies that address the entire population, especially those with rising risk. Representing over a quarter of the U.S. population, those at risk for chronic conditions like diabetes or heart disease are tomorrow's high utilizers. For example, studies show 15 to 30 percent of pre-diabetics will become diabetics within five years if they don't take steps, which more than doubles their medical costs. That will eventually put organizations taking on risk-based contracts in the red.

Q: What are the biggest challenges in developing a sustainable PHM strategy?

MB: First, you can't manage what you don't have insight into. It's surprising how hard it is to take data from different sources to accurately identify risk. For example, one of our customers had hundreds of different mappings for a single hemoglobin A1c value, even though all the practices used the same EHR vendor. Without a solution that can translate these different data points into a single meaningful measure, we will miss many of those at risk for diabetes. Once you identify risk, you then must provide effective care management, including appropriate proactive measures to manage utilization and costs.

Q: How does home healthcare play a role in PHM?

MB: For too long, we've accepted a loss of visibility into our patients as soon as they leave our walls, which presents a significant challenge, and puts the quality of care at risk. Today, aided by connected technology solutions, we are able to overcome this and achieve a holistic view of the patients daily life- whether or not they interact with the traditional healthcare system or not. Healthcare provided and managed while the patient is at home can positively impact health outcomes and utilization For example, for someone with heart failure, providers can use electronic scales and other connected devices to detect subtle changes in weight and vital signs, then use telehealth to intervene proactively. Likewise, electronic sensors and medication adherence devices can be combined with emergency response devices to keep elderly people safe and independent in their own homes for a longer time.

Q: Can you share any best practices?

MB: While an EHR is a necessary base, a comprehensive, agnostic PHM platform can help you manage the entire population. We created a three-step process we refer to as "Understand, Navigate and Activate."

Understand — First, health providers must understand their populations, gaining visibility into cost, quality and patient risk based on aggregated patient data across multiple settings and sources.
Navigate — Once you have analyzed and stratified your population, you can help patients navigate to appropriate care, providing guidance about their best next health interaction.
Activate — You then can activate patients to more continuous health by using digital technologies and services to help you coordinate care across the continuum and cost-effectively extend access.

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